A clinical study of posterior-medial dislocation of elbow joint / 中华骨科杂志

ABSTRACT

Objective:To analyze the clinical characters and results of the posteromedial dislocation of elbow.Methods:From January 2014 to March 2016, a retrospective observational study of 15 patients with posteromedial elbow dislocations was performed. There were twelve males and three females, the mean age was 44 years old (23-64 years old). There were fourteen complex dislocations and one simple dislocation. The signs of posteromedial dislocation included changes of carry angle and varus deformity. Dimple signs were found in 8 patients. Conservative treatment was used in two cases (one simple dislocation and one complex disclocation). Operative treatment was performed in the other 13 cases with complex dislocations, in which five were fixed by hinged external fixator due to instability. The ranges of elbow and forearm movement, visual analogue score (VAS) and Mayo elbow performance score (MEPS) were recorded before treatment and at the last visit after average 18 months (17-21 months) of follow-up.Results:Before treatment, the average arc of extension-flexion was 9.3°±1.3° (5°-15°), the average range of forearm pronation was 6.4°±1.4° (0°-10°), supination was 4.3°±1.7° (0°-10°); VAS averaged 8±0.3 scores (7-9 scores); MEPS averaged 15.7±4.3 scores (5-35 scores). At the last follow up, the average arc of extension-flexion was 105°±5.2° (90°-130°), the average range of forearm pronation was 60°±8.5° (20°-80°), supination was 76°±9.5° (20°-90°); VAS averaged 0.4±0.2 scores (0-1 score); MEPS averaged 95.7±2.3 scores (85-100 scores). Significant different was found in all index by paired t test ( P<0.001). No instability of elbow was found in physical and radiology test in all follow-up visit. Conclusion:Posteromedial dislocation of elbow is rare in clinics, closed reduction can be always successful in simple dislocations; open reduction would be necessary in the majority of complex dislocations. However, relatively satisfied clinical results could be achieved.